Until recently, few successful treatment options existed for patients with ANCA (anti-neutrophil cytoplasmic antibodies) positive vasculitis and the illness was associated with high mortality rates. Advances in medical treatment have improved rates of survival substantially. Psychosocial aspects of the illness, however, remain largely unexplored. Yet, the course of the illness and its treatment with effective but potentially toxic drugs raise significant challenges for patients and their spouses. Paralleling the advances in the medical treatment of ANCA vasculitis, are advances in the conceptualization and operationalization of important psychological constructs including social support and perceived control. Although these variables have been studied for decades, they have often been approached in a nonspecific way that paid little attention to underlying processes. More recently, approaches have been developed that capture the true transactional nature of social support and perceived control and have provided new insights concerning how they can be beneficial. This study proposes to examine these processes among patients with ANCA vasculitis. We hypothesize that disease activity will have an adverse effect on psychological adjustment in both patients and spouses. We further hypothesize that this effect will be mediated by aspects of support and perceived control. More specifically, we believe that two specific, process-oriented facets of support, empathic accuracy and transformation of motivation, and an interpersonally-defined facet of perceived control, dyadic efficacy, will attenuate the adverse affects of illness severity. To test these hypotheses, we will study 120 couples in which one partner has ANCA vasculitis. At two time periods, we will assess empathic accuracy behaviorally using the "dyadic interaction paradigm" technique and transformation of motivation by two different self-report methods. On these same occasions, we will also assess dyadic efficacy, using a scale currently under development as part of a related research project. In addition to testing these hypotheses, a further aim of the proposed study is to develop a self-report measure of perceived empathy that avoids the limitations of existing instruments and that can be validated against the gold-standard, behaviorally-based, dyadic interaction paradigm procedure. Such a tool would greatly enhance the utility of empathic accuracy by making its assessment less demanding to investigators. In summary, the proposed research will apply novel, state-of-the-art methods of assessing process-oriented features of social support and perceived control to a patient population that has been largely overlooked by social and behavioral scientists. Through this research, we hope to gain new insights into how these patients and their spouses adjust to ANCA vasculitis that will eventually lead to improvements in their quality of life.